New tool to predict the risk of death in COPD

August 28, 2009

Researchers have developed an index scale to help physicians predict a patient's risk of dying from chronic obstructive pulmonary disease (COPD). The ADO index can help physicians assess the severity of a patient's illness to determine the appropriate level of treatment. COPD, which comprises emphysema and chronic bronchitis, is a major public health problem and it is the fourth leading cause of death in the U.S. The study of the ADO index is published in the August 29 edition of the Lancet.

Currently, the BODE index is used by chest physicians to estimate a patient's risk of death from COPD. The index is based on an assessment of body-mass index, airflow obstruction, dyspnea and exercise capacity. However, the BODE index is rarely used in primary care settings where most patient treatment options are managed, because exercise capacity cannot be easily measured in the typical doctor's office.

"The burden from COPD is so enormous that we need to reach out to any doctors who care for COPD patients. The ADO index can be used in any setting and we hope that it will serve as a basis for more individualized treatment selection in the near future," said Milo A. Puhan, MD, PhD, associate professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health and lead author of the study.

For the study, Puhan and colleagues developed a simplified BODE index and the ADO index, which included age, dyspnea and airflow obstruction. The research team compared the predictions of the BODE index with the 3-year risk of all-cause mortality from 232 COPD patients from Switzerland. The updated BODE index and the new ADO index were then validated with a cohort of 342 COPD patients from Spain.

According to the study, the updated BODE and ADO indices accurately predicted 3-year mortality and matched the observed mortality in the Spanish cohort well with little difference between predicted and observed mortality compared to the original BODE index, which performed poorly at predicting 3-year risk of mortality. The analysis of the BODE index showed a 36 percent relative under prediction in the Swiss cohort and a 39 percent relative over prediction in the Spanish cohort.

COPD affects more than 16 million Americans and it is the only disease among the top 10 causes of death with a rising mortality rate in the United States. It is predicted to be the third largest cause of death by 2020 and has already reached worldwide epidemic proportions.

Source: Johns Hopkins University Bloomberg School of Public Health (news : web)

Related Stories

Recommended for you

New genetic research from an international team including McMaster University, University of Helsinki, Vilnius University and the University of Sydney, suggests that smallpox, a pathogen that caused millions of deaths worldwide, ...

Psoriasis is well-known for causing too many skin cells on elbows, knees, and across the body, but people living with psoriasis may also be at an increased risk of heart disease. Effects of overactive immune cells in the ...

In a new study, researchers have modified a rabies virus, so that it has a protein from the MERS virus; this altered virus works as a 2-for-1 vaccine that protects mice against both Middle East Respiratory Syndrome (MERS) ...

Using state-of-the-art brain imaging technology, scientists at the National Institutes of Health filmed what happens in the brains of mice that developed cerebral malaria (CM). The results, published in PLOS Pathogens, reveal ...

0 comments

Please sign in to add a comment.
Registration is free, and takes less than a minute.
Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.